Introduction

The purpose of this page is not to scare off potential visitors to South Africa as a birding or hiking destination and in particular KwaZulu Natal, but rather to inform travellers and thus enable them be adequately prepared to deal with potential health risks. Most visitors leave us unscathed and this despite the amazing chances some people take.

As much of the birding in Zululand is done in a sub-tropical area, visitors to the region need to be aware of the potential health risks and precautions necessary to avoid contracting diseases such as malaria, cholera and tick-bite fever which occur in certain areas. Having said that, it is important that the prospective visitor not be alarmed by the presence of these diseases. Simple, common-sense precautions should be effective in avoiding infection and thus ensuring a healthy trip.

Malaria is probably the most serious of the three diseases mentioned above and as it has a three week incubation period, visitors who, on their return from their trip, develop flu-like symptoms, (headache, fever, chills, diarrhoea), should advise their doctor of the fact that they have spent time in a malaria area. Should one wish to avoid contracting malaria, one should in the first place avoid being bitten by mosquitoes by staying indoors after dark, using insect repellents on exposed skin and keeping as little skin as possible uncovered after dusk. Pyrethroid insect repellents (Tabard or Peaceful Sleep are good brands) and mosquito nets for sleeping areas are also strongly recommended.

The following websites offer excellent information and advice on malaria prophylaxis and malaria in general:

www.travelclinic.co.za/ and www.parks-sa.co.za/ (under the latter site, look up Kruger National Park which has its own malaria page).

Cholera - Recently caused a major epidemic in South Africa. This fact should not raise fears for potential visitors. Cholera is spread by contaminated food and water and not person to person, thus if adequate care is taken in ensuring that food has been properly prepared and water adequately treated there is little risk of contracting the disease. Good personal hygiene should also be practised and care should be taken to avoid bathing in potentially contaminated water. It is safe to drink the tap water in South Africa.  However, it is not advised that you drink waters from streams, lakes or rivers.

Cholera can be prevented by taking note of the following points:

1. Water treated with chlorine is safe to drink. This includes water from municipal water supplies, most tap water, or other water properly treated with household bleach or water purifying tablets.

2. Do not drink water from open water sources such as streams, rivers, springs, dams or ponds before boiling it for 1 minute or treating it with a 0,5% sodium hypochlorite solution, (one teaspoon -5ml- in 25 litres of water left to stand overnight). Ordinary household bleach is quite safe to use for this purpose.

3. Avoid eating unpeeled fruit or food from street vendors where you cannot be sure that such food has been properly prepared (boil it, cook it, peel it or forget it!).

4. WASH YOUR HANDS before eating, before preparing food, after using the toilet.

5. Do not swim or fish in polluted waters.

Cholera causes severe diarrhoea and vomiting. The following hints will help in the early treatment of any form of severe diarrhoea (including cholera) to prevent severe dehydration:

1. Take large volumes of fluid by mouth if not vomiting.

2. Make a simple rehydration solution by adding to one litre of boiled water, 8 teaspoons of sugar and one level teaspoon of salt.

3. If diarrhoea is severe or vomiting prevents the taking of fluids by mouth, get to a place where fluids can be given by intravenous drip (clinic or hospital).

4. Antibiotics are generally not required to treat cholera.

Further information on cholera for travellers can be obtained at the following websites:

www.who.int/health-topics/cholera.htm
www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera_g.htm

Tick-Bite Fever as its name suggests, is the result of a bite from a tick or ticks infected with the organism Rickettsia conori. The incubation period (from the time of the bite to onset of symptoms) is approximately 10 to 14 days. The affected individual develops a severe headache, fever, marked inflammation at the bite site, (the centre of which may become black in colour) and painful, swollen lymph nodes ("glands") close to the bite site. Should such symptoms develop after a visit to South Africa, advise your doctor to consider tick-bite fever as a possible diagnosis and to prescribe the appropriate antibiotics.

Prevention of this disease is best achieved by avoiding getting bitten by ticks. This can be done by wearing long socks or trousers, or if the weather demands lighter clothing, treating exposed skin with an insect repellent such as di-ethyl toluamide (DEET). After walking in the bush, careful inspection of the skin and clothing is also important to identify and remove ticks (in their nymphal forms they may be minute so look carefully!). Avoid killing ticks by crushing them between the fingers as this exposes one to Rickettsiae and other harmful pathogens the tick may be harbouring. The best option is to drop the offending creatures into a fire or down the toilet.

Other Health Risks Do Occur When Walking In The Veldt (as when hiking, birding etc.:

Perhaps the most important of these is Snake Bite. While reports of birders being bitten by snakes are rare, the possibility of encountering snakes exists. Unless directly confronted, snakes generally prefer to retreat from humans rather than attack and usually only bite when provoked or cornered, so the simple advice is give snakes room to escape and avoid playing with them. Should you be unfortunate enough to be bitten, stay calm and get those with you to help you. If you can, get a good look at the snake as an accurate description will help determine appropriate treatment should this be necessary. Attempt to immobilise the affected limb by splinting it, don not cut or suck on the bite and only apply a tourniquet if you are sure that the snake which did the biting was a cobra or mamba and you know how to apply and use a tourniquet. Otherwise, if you have one, apply a crepe bandage firmly along the length of the affected limb. Get to a doctor or health care facility as quickly as possible to obtain professional help. Should you be unfortunate enough to encounter a spitting cobra and get a dose of venom in your eyes, rinsing with large volumes of clean water or milk (make sure it is pasteurised) is the best treatment in the first instance, but again, professional help should be sought to avoid permanent damage to the eyes.

Sunburn may seem a minor enough malady, but it can be quite debilitating and should be avoided, not only because of the short-term discomfort it causes, but also because of the potential risks of skin malignancies and cancers arising from excessive sun exposure later in life. The importance of using wide-brimmed hats and appropriate sun-screens cannot be stressed enough!

Closing Remarks

Common sense and appropriate precautions should ensure a happy, healthy and productive stay in our region. Enjoy!